基于“营气衰少,卫气内伐”论治绝经相关失眠  

Discussion on the treatment of menopausal related insomnia based on the theory of ‘insufficient energy of the camp,and internal invasion of the guard qi'

作　　者：王仃仃 孙冰 李冰冰 武琦琪 宋宗辉 刘禹萱 WANG Dingding;SUN Bing;LI Bingbing;WU Qiqi;SONG Zonghui;LIU Yuxuan(PhD Candidate,2021,The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Nephrology Department,Jining Branch of Xiyuan Hospital(Jining Traditional Chinese Medicine Hospital),Jining 272000,China;School of Integrated Traditional Chinese and Western Medicine,Jining Medical College,Jining 272067,China;The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jining 250355,China)

机构地区：[1]山东中医药大学第一临床医学院2021级博士研究生,济南250355 [2]西苑医院济宁医院(济宁市中医院)肾病科,济宁272000 [3]济宁医学院中西医结合学院,济宁272067 [4]山东中医药大学第一临床医学院,济南250355

出　　处：《中华中医药杂志》2025年第1期257-260,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(No.82104920)。

摘　　要：绝经相关失眠是指与绝经相关的、不能归因于其他原因的失眠,孙冰教授认为本病核心病机为“营气衰少,卫气内伐”,是卫气独行于阳而不入于阴所致。针对这一核心病机采用补虚泻实、调和营卫的治则,治法上强调补气养血,同时注重疏肝解郁、化痰清火、活血通窍,孙冰教授临证结合仝小林院士“态-靶辨治”理论,在辨证的基础上选用靶向安神药,具体辨证处方思路为:气血亏虚、心神失养者,归脾汤加合欢皮、合欢花、首乌藤等;少阳郁滞、痰火扰神者,柴胡加龙骨牡蛎汤加郁金、石菖蒲、远志等;寒热错杂、阴阳失交者,乌梅丸加合欢皮、合欢花、牡蛎等;瘀血阻窍、神不内守者,桂枝茯苓丸加合欢皮、首乌藤、丹参等。Menopausal related insomnia refers to insomnia related to menopause and cannot be attributed to other reasons.Professor SUN Bing believes that the core pathogenesis of this disease is ‘insufficient energy of the camp,and internal invasion of the guard qi',which is caused by the independent movement of the guard qi in the yang and not in the yin.In response to this core pathogenesis,the treatment principle of tonifying deficiency,purging excess,and harmonizing yin and health is adopted.The treatment method emphasizes tonifying qi and nourishing blood,while paying attention to soothing the liver and relieving depression,resolving phlegm and clearing fire,promoting blood circulation and opening the orifices.Professor SUN Bing combines the theory of ‘state target differentiation' with academician TONG Xiaolin,and selects targeted sedatives based on syndrome differentiation.The specific prescription for syndrome differentiation is as follows:For those with qi and blood deficiency and loss of mental and spiritual nourishment,Guipi Decoction with Albizia bark,Albizia flower,Polygni Multiflori Caulis,etc.;those with Shaoyang stagnation and phlegm fire disturbing the spirit,Chaihu Plus Dragon Bone Oyster Decoction with Curcuma aromatica,Rhizoma acori tatarinowii,Radix polygalae,etc.;those with a mix of cold and heat,and a lack of interaction between yin and yang,Wumei Pill with Albizia bark,Albizia flower,oyster,etc.;those with blood stasis obstructing the orifices and lack of internal protection of the mind,Guizhi Fuling Pill with Albizia bark,Polygni Multiflori Caulis,Salvia miltiorrhiza Bunge,etc..

关 键 词：营气衰少 卫气内伐 绝经相关失眠 调和营卫 孙冰 中医经验 

分 类 号：R256.23[医药卫生—中医内科学]